Burn Classification

Burn injuries are caused by a variety of agents—hot liquids, flame, flash
(i.e., explosions), chemicals, electricity and contact with hot objects. The most
important classification of burn wounds refers to the extent and depth of the
injury. In most cases, the extent and depth of the burn wound are the most
significant factors contributing to the seriousness of injury of the burn
victim.

EXTENT OF INJURY

The extent of a burn wound is defined as the percentage of total body surface
damaged and may be determined by the Rule of Nines. This divides the body into areas
of 9% or multiples of nine (figure I) and is modified for estimating the extent of
burn injury in children (figure II).

DEPTH OF INJURY

The depth of a burn injury refers to the amount of skin, and on some occasions
other tissue, damaged or destroyed. Skin has two layers, the superficial epidermis
and the deeper dermis that overlies subcutaneous tissue. Burn injuries are defined
as Superficial (1st Degree), Partial Thickness (2nd Degree) and Full Thickness (3rd
Degree).

Superficial Burn (1st Degree Burn)
112 degrees F

minor damage of the epidermis

red, tender, dry, no blisters

i.e., sunburn, heals in three to six days

Partial Thickness Burn (2nd Degree Burn)
140 degrees F

impacts epidermis and dermis

blisters are thick walled and sometimes ruptured

color is mixed red and white

painful, especially if pressure is applied

heals in three to six weeks, potential scarring, may
require hospital admission, surgery

Full Thickness Burn (3rd Degree Burn)
158 degrees F

destruction of epidermis and dermis

high risk of infection, loss of temperature control

skin appears white, black, gray, leathery and charred,
dry

requires hospital admission, surgery

months, years to heal

All burns should be treated with concern. It is important to keep in mind the golden
rule of burn management: If someone has a burn on their body exceeding the size of
the palm of their own hand, where blisters are present, burns to the genitalia, face
or to any flexion point, this person should seek medical attention. All electrical
burns require medical attention.

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